Is Subacromial Impingement Syndrome Causing Your Shoulder Pain?

What Is Subacromial Impingement Syndrome?

Subacromial impingement syndrome (also known as shoulder impingement syndrome) is a painful condition that develops when your rotator cuff repeatedly rubs between your upper arm (humerus) and the outer tip of your shoulder (acromion).

This repeated friction results in irritation, pain, and swelling and can cause the space between the rotator cuff and acromion to become more narrow.

The subacromial space is located above your glenohumeral joint (ball and socket) but below your acromion.

Within your subacromial space, you will find your rotator cuff tendons, your subacromial bursa (a fluid-filled sac that prevents friction between the rotator cuff tendon and acromion), biceps tendon, and coracoacromial ligament.

Due to a lack of space, it becomes easier for your acromion to “impinge on” the muscles and rotator cuff tendons. If your muscles and tendons are not able to glide through smoothly, they can easily get pinched or compressed, causing inflammation and irritation.

Shoulder impingement syndrome can include a wide variety of subacromial pathologies, including subacromial bursitis, partial rotator cuff tears, and rotator cuff tendinosis.

Is Subacromial Impingement Common?

Shoulder impingement is very common, and it can occur in any age group but typically affects patients with increased activity levels or repetitive movements.

Athletes (volleyball players, baseball pitchers, weightlifters, etc.), manual laborers, and people working at a desk for long periods.

Shoulder Impingement Syndrome Symptoms

If you have shoulder impingement syndrome, you may experience:

• Pain that typically develops over time (ranging from a few weeks to months)
• Gradual or sudden onset of pain
• Pain that spreads from the outer front (anterolateral) of your shoulder to the humerus
• Pain that tends to worsen at night and can cause difficulty sleeping
• Restricted shoulder motion/pain when your lift your arm or participate in overhead activities (reaching/extending your arms overhead)
• Pain when you lay on the injured side
• Decreased muscle strength

Causes of Subacromial Impingement Syndrome

Subacromial impingement can be caused by various factors, including:

• Swollen, thickened, or torn rotator cuff tendons — These can repeatedly rub against or catch in the acromion (which is located at the top edge of your shoulder blade).
• Overuse — Small tears can gradually develop in the soft tissue from repetitive overhead movements. This results in your tendons and bursa becoming inflamed, causing friction between your tendons and coracoacromial arch.
• Muscle weakness — When your shoulder muscles are weak, they can cause your arm bone to deviate from its normal position and move closer towards the acromion. This results in your rotator cuff muscles getting pinched on a more frequent basis.
• Weakened shoulder blade muscles — There is a possibility that the space where your shoulder tendons lie will become reduced if there is weakness in your shoulder blade (scapula) muscles. This increases the likelihood that your tendons will be pinched.
• Anatomical factors — Variations of shape and gradient of your acromion can also increase your chances of developing shoulder impingement.
• Injury
• Poor posture

How Is Shoulder Impingement Diagnosed?

Your specialist will begin by reviewing your medical history and doing a thorough physical examination of your shoulder. Your exam may include:

• Strength and motion tests
• Observing your posture
• X-rays of the affected shoulder to rule out or identify any additional conditions that may also be affecting your shoulder joint

What Are the Treatment Options for Shoulder Impingement Syndrome?

There are a variety of treatment options for shoulder impingement. The goal is to decrease your pain and resolve the mechanical problem that has caused the irritation. This can be accomplished by both non-surgical and surgical methods.

If your impingement has not caused damage to your ligaments and tendons, or you are at the early stage of impingement, then conservative treatment may be effective in helping reduce your pain.

Conservative Treatments for Shoulder Impingement Syndrome Include:

• Rest
• Ice
• Nonsteroidal anti-inflammatory medication
• Physical therapy—Your physical therapist will use exercises that focus on training your scapular stabilizers and rotator cuff muscles so that they can function properly.
• Manual therapy—This technique of gently moving your muscles and joints can improve your range of motion.
• Localized cortisone injections

If your shoulder does not respond to these non-surgical treatments or an MRI shows a complete rotator cuff tear, then surgical treatment may be considered.

Surgical Treatment for Subacromial Impingement Syndrome:

Typically, if surgical intervention is needed to treat shoulder impingement, it would be done arthroscopically.

Arthroscopic subacromial decompression surgery is a minimally-invasive procedure used to treat shoulder injuries.

During the procedure, your surgeon will look into the subacromial space by using small cameras and instruments to repair the damage and reduce your pain.

Before starting treatment, though, your specialist will review all the treatment options that are available to you to ensure that the right methods are chosen for your goals and lifestyle.

How Long Will it Take for Subacromial Impingement to Heal?

The healing time for a subacromial impingement will vary from person to person. If you are consistent in adhering to a conservative treatment plan, you may start to see improvement within a few weeks or months.

If surgery is recommended, your healing process will require additional time. However, once your surgery is complete, physical therapy can be very helpful in your recovery journey.

Although having shoulder pain can be a source of great stress, you do not have to suffer forever. Schedule an appointment with one of our experts at OrthoNeuro for a proper diagnosis of your symptoms.

We have several offices located throughout the Greater Columbus area. We can help you return to a life that you love. Contact us today!